Moores C J, Taylor A M, Cowap S, Roberts R, Gunasinghe K A M M, Moynihan P J
Adelaide Dental School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia.
Southern Adelaide Local Health Network, Bedford Park, South Australia, Australia.
JDR Clin Trans Res. 2025 Jul;10(3):227-245. doi: 10.1177/23800844241280717. Epub 2024 Oct 11.
The adolescent diet is high in sugars compared with other age groups. Effective approaches to support sugar reduction by adolescents are needed as part of caries prevention.
To systematically review peer-reviewed evidence (1990 to 2023) to identify effective behavior change techniques (BCTs) for sugars reduction in adolescents aged 10 to 16 y.
Nine databases (CINAHL, Cochrane, Dental and Oral Sciences Source, EMBASE, MEDLINE, PubMed, PsycINFO, Scopus, and Web of Science) were searched. Identified articles were screened independently in duplicate for eligibility. Interventions were eligible if they aimed to change adolescent dietary behavior(s) and reported pre- and postsugar-relevant outcome measures. Interventions from included studies were coded using a 93-item BCT Taxonomy (Michie Taxonomy v1). Risk of bias was assessed using the Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies. Evidence synthesis by vote counting (number of studies showing positive versus null or negative effects) was applied to BCTs that were present in more than 5 interventions.
Of 16,271 articles identified, 764 were screened in full, yielding 35 studies (in 43 papers), of which 3 were uncodeable. BCTs coded in interventions covered 11 of 16 BCT clusters and 25 of 93 individual BCTs in the BCT taxonomy. The median number of BCTs applied per study was 3 (interquartile range 2-6). Evidence synthesis indicated that the BCTs most positively associated with a positive reduction in sugars were (with the percentage of strong-/moderate-quality studies applying these techniques that successfully reduced sugars intake in brackets) feedback on behavior (100%), information on social and environmental consequences (100%), problem solving (75%), and social comparison (75%).
Notwithstanding limitations in available data, the current evidence most strongly supports the use of BCTs relating to feedback on behavior, providing information on the social and environmental consequences, include problem solving and making social comparisons, to lower sugars intake in adolescents.Knowledge Transfer Statement:The results of this study will enable clinicians to provide more effective dietary advice when supporting dietary behavior change to reduce sugars intake in adolescents. The results may also be used by researchers to guide future directions for research into effective sugars reduction in adolescents.
与其他年龄组相比，青少年饮食中的糖分含量较高。作为预防龋齿的一部分，需要有效的方法来支持青少年减少糖分摄入。
系统回顾同行评审的证据（1990年至2023年），以确定10至16岁青少年减少糖分摄入的有效行为改变技术（BCTs）。
检索了九个数据库（CINAHL、Cochrane、牙科和口腔科学源数据库、EMBASE、MEDLINE、PubMed、PsycINFO、Scopus和Web of Science）。对检索到的文章进行独立的双人筛选以确定其是否符合要求。如果干预措施旨在改变青少年的饮食行为并报告了与糖分相关的前后结果测量，则该干预措施符合要求。使用93项BCT分类法（Michie分类法v1）对纳入研究的干预措施进行编码。使用有效公共卫生实践项目定量研究质量评估工具评估偏倚风险。对存在于5项以上干预措施中的BCTs采用投票计数法（显示积极效果与无效或消极效果的研究数量）进行证据综合分析。
在识别出的16271篇文章中，对764篇进行了全文筛选，产生了35项研究（43篇论文），其中3项无法编码。干预措施中编码的BCTs涵盖了BCT分类法中16个BCT集群中的11个和93个个体BCTs中的25个。每项研究应用的BCTs中位数为3（四分位间距为2 - 6）。证据综合分析表明，与糖分摄入量积极减少最密切相关的BCTs是（括号内为应用这些技术成功降低糖分摄入量的高质量/中等质量研究的百分比）行为反馈（100%）、社会和环境后果信息（100%）、问题解决（75%）和社会比较（75%）。
尽管现有数据存在局限性，但当前证据最有力地支持使用与行为反馈、提供社会和环境后果信息、包括问题解决和进行社会比较相关的BCTs，以降低青少年的糖分摄入量。知识转移声明：本研究结果将使临床医生在支持青少年改变饮食行为以减少糖分摄入时能够提供更有效的饮食建议。研究结果也可能被研究人员用于指导未来关于青少年有效减少糖分摄入的研究方向。
